Many children with PDA may become so anxious about social situations combined with the associated demand of going out that they become completely housebound. This can be especially worrying for parents to deal with and may be deeply distressing and frustrating for the individual themselves

There may be many reasons behind this inability to leave the home and, in some cases, these reasons may all be intrinsically linked with each other.

The reasons behind the social anxiety and subsequent social isolation may be due to some or all of the reasons stated below.

Something may have happened to cause them to have a deep fear of the outside world. In the case of my daughter, going out became noticeably more difficult for her following being restrained at school during a meltdown. This led to flashbacks and panic attacks within the home. The event and the humiliation that she felt had simply traumatised her.

Leaving the home is, after all, a demand that they may not be able to comply with no matter how much they may want to.

Maturing years and self awareness may mean that the individual does not want to experience a meltdown in public and in full view of others. Therefore it becomes safer and easier to not place themselves in that situation in the first place.

The outside world and what may happen while they are out of the safe confines of home is the unknown, totally unpredictable and outside of their control.

So what can you do if your child has become a complete recluse and no longer leaves the home. Well, in some cases, it may be that the child just needs a complete period of demand detox in order to restore and replenish emotional strength. Therefore, in some instances facilitating a demand free environment and not pushing or continually trying to tempt the individual outside may be the best short term option.

Once the individual begins to show signs of emotional recovery and appears more relaxed and less anxious you may be able to begin very small and tentative steps to help them access the outside world in very small bite size chunks.

It may be helpful to encourage them to just step outside the front door for a few minutes and then to return to the house. They need to gain the confidence that nothing bad is going to happen to them.

Next you may be able to build on this and make it to the car for a short car journey with their favourite music on.

You may be able to build on this and encourage a visit to the cinema or to the local shop. Try to pick times that are not busy so that they don’t become overwhelmed from either a social or sensory aspect.

Always provide the safety net of letting the individual know that they can come home as soon as they begin to feel anxious or want to.

If a trip is successful you can repeat this several times over which will increase the individuals confidence in being able to successfully access these events without undue stress due to the event becoming predictable.

As confidence grows and the huge fear of the outside world begins to subside you may be able to assist them to gradually branch out into more areas.

Hopefully you will eventually find yourself in the situation of having a child that is able to access regular but familiar and predictable events.

Sometimes, even after a period of successful integration in the outside world, there may be setbacks when the individual reverts to isolation within the home. It may just be that the individual simply requires some recuperation time. Try to facilitate this because it may be that as the individual recovers he/she is able to pick up where they left off.

My daughter has gone from being a complete and total recluse to now managing quite a lot of events outside of the home. Very often though, she does require periods of recovery which can vary in duration. As with so many aspects of PDA it is about facilitating things when the individual is able to cope and then pulling back when their anxieties are high or when they need to have down time.